Quadriceps and hamstrings muscle control in athletic males and females

The aim of this study was to investigate whether athletic males and females have differences in their quadriceps and hamstrings muscle control strategies. Twenty‐four people (12 males, 12 females) active in level I activities volunteered to participate. The subjects' muscle control strategies were studied using electromyography and a target matching protocol that assesses one's ability to produce force with control. The degree of control exhibited in the subjects' quadriceps and hamstrings muscle activation strategies was evaluated by calculating specificity indices for each muscle using circular statistics. Females displayed significantly lower specificity than males in their vastus medialis (p < 0.001), rectus femoris (p = 0.044), and lateral hamstrings (p = 0.001) muscle activity patterns, but similar specificity in their vastus lateralis and medial hamstrings activity patterns. Females also used a significantly higher magnitude of vastus lateralis (p < 0.001) and vastus medialis (p < 0.001) muscle activity than males to achieve the same relative force level. These findings indicate athletic males and females have differences in their knee muscle control strategies. © 2008 Orthopaedic Society. Published by Wiley Periodicals, Inc. J Orthop Res 26:800–808, 2008     

Differences in basal and postexercise osteocalcin levels in athletic and nonathletic humans

Summary The levels of serum osteocalcin, in addition to other parameters, were monitored in athletic (N=9) and nonathletic (N=10) university male students before, immediately after, and 60 min after 30 min of exercise on a running ergometer and at a constant workload of approximately 50% of their maximum capacity; there was adequate replenishment of drinking water. In both groups, the increase in serum parathyroid hormone levels observed immediately after exercise correlated well with a decrease in ionized calcium as well as the total calcium, and also with an increase in serum phosphorus, whereas the concentration of serum albumin remained stable. The response of serum osteocalcin differed between the two groups, in that (1) the concentration before exercise was significantly higher in athletic than in nonathletic students (P<0.001), and (2) the maximum level was evident in the former group 60 min after exercise, whereas it was present in the latter group immediately after exercise. We speculate that athletic subjects have a higher turnover of bone status compared with nonathletic subjects.     

Body composition in adolescent idiopathic scoliosis

Study design

A controlled prospective cross-sectional case study.

Objective

To investigate body mass index (BMI) and corporal composition in girls with adolescent idiopathic scoliosis (AIS) and compare them with a normal population matched by sex and age.

Summary and background data

There is controversy as to whether there are real anthropometric alterations in patients with AIS. Relative to the weight or the BMI, some studies find differences and other studies do not detect them. AIS and anorexia nervosa (AN) make their debut during adolescence and both may be associated with an alteration of their subjective physical perception. Some authors propose a link between AIS and AN supported both by an alteration of physical perception and lower BMI. No studies on body composition in AIS have been published.

Methods

Adolescent idiopathic scoliosis patient surgery candidates during 2008 were studied. Body composition was evaluated using the bioelectrical impedance analysis (Bodystat, Isle of Man, UK). A study population of more than 5,000 patients that was published by Kyle et al. (Nutrition 17:534–541, 2001) was chosen as a control (group 1). Another control group (group 2) of healthy volunteers matched by sex and age was selected among a school age and university population in Barcelona, Spain. A variance analysis was used to analyze differences between the mean values of the control group 1, the European control group, and the AIS patient surgery candidates (Epiinfo 6.2001). Comparisons between the AIS patients and control group 2 were performed with the T Student test of unpaired samples using the SPSS 15.0 (Statistical Package Social Science) software.

Results

Twenty-seven women with a mean age of 17.4 years. BMI was 18.9 kg/m² (SD 1.7; 95 % CI 18.31–19.73). In the variance analysis, a significant difference between AIS and group 1 in BMI was observed (21.0 vs. 18.9, p = 0.000004); fat-free mass (FFM = 42.6 vs. 38.9, p = 0.0000009) and fat mass (FM = 15.6 vs. 13.7, p = 0.03). Significant differences in BMI (22.13 vs. 18.9, p = 0.001; 95 % CI difference 1.85–4.60), fat mass index (FMi = 7.17 vs. 4.97, p = 0.000; 95 % CI difference 1.36–3.05) and fat-free mass index (FFMi = 14.95 vs. 13.09, p = 0.001; 95 % CI difference 0.26–1.86) between AIS and group 2 were also seen.

Conclusion

The conclusion is that there is a real alteration of body composition in AIS. The BMI, FFMi and FMi are lower than in the general population in the series under study.     

男性青少年身体成分与骨矿含量的关系

为了解青少年身体成分中瘦体重和体脂含量究竟那种成分对骨矿含量影响起主要作用，我们对５８名男性青少年（年龄１７．２±０．７岁，范围：１５．５—１８．７岁）进行人体测量，计算出瘦体重和体脂含量，用ＢＨ－６０１２型二维扫描单光子骨密度仪测量非优势侧桡骨中远１／３处及桡骨超远端骨矿含量（ＢＭＣ，ｇ）、骨宽（ＢＷ，ｃｍ）、骨密度（ＢＭＤ，ｇ／ｃｍ２），为消除身高的影响分别计算桡骨中远１／３处和桡骨超远端ＢＭＤ／身高值（ＢＭＤ／Ｈ，ｇ／ｃｍ３）。以桡骨中远１／３处及桡骨超远端的ＢＭＣ、ＢＭＤ、ＢＭＤ／Ｈ作因变量，年龄、身高、瘦体重、体脂含量作自变量进行多元线性回归分析，结果表明瘦体重和体脂含量均与骨矿含量有关（Ｐ＜０．０５），但经骨形态即骨宽较正的骨密度及身高校正的ＢＭＤ／Ｈ仅与瘦体重有关（Ｐ＜０．０５），因此说明男性青少年身体成分中瘦体重对桡骨超远端骨密度的影响作用较大。     

Fertility in males after childhood,adolescent, and adult inguinal operations

Background/purpose

Inguinal hernia repair and orchidopexy are among the most common operations in boys. The impact on future fertility has not been conclusively defined. This study evaluates sperm quality after previous inguinal surgery.

Peak trabecular vertebral density: A comparison of adolescent and adult females

Summary To determine when spinal bone density reaches its peak, the trabecular vertebral density was assessed, via quantitative computed tomography, among females from two age groups: (1) adolescents (aged 14–19 years; n=24); and (2) young adults (aged 25–35 years; n=24). The adolescent girls had a higher mean trabecular vertebral density (P<0.01), suggesting that spinal density reaches its peak around the time of cessation of longitudinal growth and epiphyseal closure.     

Comparison of craniofacial measurements of young adult African-American and North American white males and females

Surgical correction of craniofacial disfigurements depends for its success on precise knowledge of the craniofacial norms of the patient's racial/ethnic groups. The norms of North American whites should be restricted to patients of Caucasian origin and not applied to members of other races. This study therefore sought to determine differences in anthropometric measurements of the craniofacial complex between African-American and North American white subjects of both sexes and of similar age (18-25 years old). The study group consisted of healthy young adult African-Americans, 50 males and 50 females. The analysis of craniofacial morphology was based on 51 anthropometric measurements: 9 cranial, 10 facial, 8 orbital, 14 nasal, 4 oral and 6 auricular. The results were compared with 51 norms previously established for North American whites in the same age group, generally based on 109 males and 200 females, fewer in comparisons of some nasal measurements (ac-ac, sbal-sbal, ac-sn, nostril axis). Highly significant differences between groups were found in every craniofacial region, especially in the orbital and nasal areas, and confirmed the need to establish separate norms for African-Americans to guide corrective surgery of the head and face.     

Magnetic resonance imaging assessment of tibial tuberosity-trochlear groove distance: normal values for males and females

Purpose  

The aim of this study was to report normal values of the tibial tuberosity–trochlear groove distance (TTTG) in males and females and assess the reliability of MRI in measuring TTTG.     

Comparison between males and females with lupus nephritis

Summary: In this study 17 male and 100 female cases with lupus nephritis were divided into four groups according to their clinical features at presentation. Each case was compared in order to identify sex-linked differences in their disease manifestations as well as underlying histopathological features and ultimate prognosis. the World Health Organization (WHO) histologic criteria were used for classification purposes. In all patients, age, chronicity index, duration of clinical activity of the disease before kidney biopsy and follow-up periods were statistically similar in the two groups of males and females. However, males had a significantly higher activity index in comparison to females at the time of initial kidney biopsy. In addition, diffuse proliferative histopathology was more common in males compared to females ( P = 0.002). Moreover, the renal and patient survival was significantly shorter in males as compared to female cases ( P = 0.0024, P = 0.0165, respectively). the proportions of males with severe lupus nephritis presenting with hypertension, reduced creatinine clearance, massive proteinuria and reduced levels of complement leading to end-stage renal disease was significantly higher compared to the females among the four clinical groups of the patients. In conclusion, our data indicates that lupus nephritis in males is a more progressive and severe disease in comparison to female cases. In addition its underlying histopathology is almost always diffuse proliferative lesions, leading to a poorer renal and patient survival in them.     

Areolar discharge and peri-areolar breast cysts in adolescent females

Nipple discharge in adolescents is well documented, and usually results from endocrine dysfunction or local breast disease. Areolar discharge, however, in healthy adolescent girls is a rare finding, and is sometimes associated with peri-areolar lumps. These patients usually present with painless discharge from around the nipple, and sometimes with a lump at the site. Some patients present with a lump only, and secondary inflammation at the site can occur. Although the lesions often resolve spontaneously, they can recur, and the treatment options are discussed. There are very few cases in the literature of areolar discharge in young girls, which perhaps reflects its incidence. The following case report of 16 patients appears to be the largest collection of patients reported with this apparently benign condition. Ultrasound examination is a useful tool in the diagnosis of this condition. Fine needle aspiration was sometimes curative, but surgical excision appeared definitive therapy.     

Effect of sub-elite competitive running on bone density,body composition and sexual maturity of adolescent females

The attainment of optimal peak bone mass during adolescence is important in the primary prevention of osteoporosis. Exercise may contribute to skeletal development and bone density during growth, although competitive exercise is suggested to have an adverse effect. This study assesses the effect of moderate exercise on the bone density of adolescent females. Additionally, other factors which significantly influence attainment of peak bone mass were identified. This was a cross-sectional study of 42 adolescent females, classified as runners (n=15) or non-runners (n=27). Nutrient intake, energy expenditure, menstrual history and pubertal stage were recorded. Bone age, skinfold thickness, body composition and bone mineral density (BMD) of total body, lumbar spine and proximal femur were measured. Statistical analyses used Student's t-test, Pearson correlation and multiple regression analyses. Runners had lower fat mass and higher lean mass, with a trend to higher BMD in all sites measured. There were no significant differences in menstrual cycle regularity, age at menarche or number who had attained menarche. Pubic hair development was similar in both groups. Breast development was delayed in runners, although this may have been a function of lower fat mass in this group. When subjects were categorized according to menarchal status, postmenarchal girls were significantly taller and heavier, with higher fat mass and significantly higher total body and lumbar spine BMD. There was no significant relationship between BMD at any site and dietary nutrient intake. Multiple regression analyses, using BMD as the dependent variable, identified running status, pubertal stage, fat mass and lean mass as significant determinants. When BMD/height was used, significant determinants in total body BMD were fat mass, pubertal stage and running status, while in the lumbar spine, only the latter two variables remained significant. In conclusion, body composition, physical activity and sexual maturity were identified as significant determinants of bone density during adolescence. Runners had significantly lower body fat than non-runners, but this did not interfere with hormonal cyclicity, and caused no detriment to their bone density. The results of this study are reassuring, since they indicate that sub-elite competitive athletics has no detrimental effect on bone mass accrual in adolescent females.     

Role of uroflowmetry in the assessment of lower urinary tract obstruction in adult males.

A group of 173 prostatic patients were submitted to a prospective study to determine the respective value of symptoms, uroflowmetry, endoscopic and radiological findings in the assessment of the degree of urinary obstruction. Uroflowmetry proved to bring objective evidence of the degree of obstruction with a reasonable degree of accuracy. Maximum urinary flow appears to be more accurate than other flow parameters in the determination of lower urinary tract obstruction.     

Urinary tract infections in adult and adolescent females of a developing community: Pattern,bacteriology and genitourinary predisposing factors

One hundred and twenty-seven consecutive adult and adolescent female patients with culture-proven urinary tract infections were analyzed to determine the pattern, bacteriology and the predisposing causes. Age ranged from 13 to 70 years (median 32, mean 35.7 years). Community acquired urinary tract infections occurred in 85%, while hospital acquired infections in 15% of cases. Urinary tract stones were the most frequently identified genitourinary predisposing causes, which occurred in 16 patients (15%). However, 52.3% of all patients had no identifiable predisposing cause.E. coli, the most frequently isolated organisms from patients with community acquired urinary tract infections, occurred in only 55.6%, while gram-positive cocci isolated from 28 patients (22%) are emerging as important hospital and community acquired urinary tract pathogens. The implications of these findings and a comparison with the reported literature are discussed.     

Bone mineral mass in males and females with and without Down syndrome

Previous bone comparison studies between subjects with and without Down syndrome (DS) were performed using bone mineral density (BMD) as the dependent variable, and mainly focused on lumbar spine region. The purpose of this study was to compare bone mineral mass adjusted for bone and body size, in limbs, lumbar spine, and femoral neck between males and females with and without DS. Subjects were 66 females (33 with DS) and 68 males (34 with DS) aged 14–40 years. Analysis of covariance (ANCOVA) was used to analyze the main and interaction effects of gender and condition on bone mineral mass. For this purpose, adjusted bone mineral content (BMC) (for bone area, height, and age), volumetric bone mineral density (vBMD) (for age), and composite indices of femoral neck strength (for age), were used as the dependent variables, corrected additionally for body composition variables selected by regression analysis. ANCOVA revealed lower lumbar spine vBMD in DS than in control subjects with (–5%, P=0.013), or without body weight adjustments (–6%, P=0.003). In femoral neck, the mean of each strength measure was also lower in DS than in control subjects. Mean differences between groups were, with and without additional adjustments for fat mass, respectively, –8% (P=0.009), and –13% (P<0.001) for compressive strength, –11% (P=0.036), and –16% (P=0.004) for bending strength, and –7% (P=0.031), and –11% (P=0.002) for impact strength. These lumbar spine and femoral neck differences between groups were highest in young adults (>20 years) and not significant in adolescents. No interaction effect was observed between gender and condition. In conclusion, DS was shown to be a risk factor for low vBMD in lumbar spine, and for diminished bone strength relative to the loads that the femoral neck must bear. Body composition did not reach statistical significance as predictor of bone differences in these sites between subjects with and without DS, suggesting that other factors may be involved in this detrimental bone status, particularly in young adults compared with adolescents.     

Bone health status of premenopausal healthy adult females in Pakistani females

Summary

Bone health status in healthy premenopausal females was assessed. We found high bone turnover in 36.8?% and vitamin D deficiency and insufficiency in 82.8 and 16.1?%, respectively, and secondary hyperparathyroidism in 25.9?% of the subjects. This is alarming as there is inability to achieve peak bone mass and predisposes to osteoporosis risk.

Purpose

This study aimed to assess bone health status in healthy females by using biochemical markers of bone metabolism in blood [N-telopeptide of type I collagen (NTx), 25-hydroxyvitamin D (25OHD), and plasma intact parathyroid hormone (iPTH)].

Material and methods

One hundred and seventy-four healthy premenopausal female volunteers were recruited from an urban residential area in Karachi. Demographic details were collected on a preformed questionnaire. Blood samples for the estimation of serum NTx, 25OHD, and plasma iPTH were taken in a fasting state. Data were analyzed using Statistical Package for Social Sciences 16.0. A p value of <0.05 was considered as significant.

Results

High bone turnover, as depicted by NTx, was seen in 36.8?% cases. Vitamin D deficiency, insufficiency, and sufficiency were seen in 82.8, 16.1, and 1.1?% respectively. Secondary hyperparathyroidism was present in 25.9?% of the subjects, while others had blunted PTH response. Significant correlates of bone health were serum 25OHD levels, duration of sun exposure, and the practice of wearing veil (p value?<?0.001).

Conclusion

Bone turnover is high with high prevalence of vitamin D deficiency in apparently healthy premenopausal females predisposing them to higher risk for development of osteoporosis.     

The treatment of post-urethrotomy incontinence in pediatric and adolescent females

PURPOSE: Until 1986 many urologists performed currently outdated, redundant internal urethrotomy as standard therapy for recurrent urinary tract infection in girls. We describe the results of therapy in patients who became incontinent due to previous internal urethrotomy. MATERIALS AND METHODS: Between 1986 and 1995, 21 female patients with post-Otis urethrotomy incontinence have presented at our department with combined dysfunctional voiding, recurrent urinary tract infection and various types of urinary incontinence partially based on bladder instability and often provoked by abdominal straining. All cases were diagnosed by repeat video urodynamics and ultrasound of the open bladder neck. Endoscopy provided proof of scarring in the bladder neck and urethra. All patients except 1 underwent conservative treatment for at least 2 years, consisting of pharmacological therapy, physical therapy and biofeedback training. Surgical therapy to cure incontinence was performed in 14 cases, including a conventional Burch-type colposuspension in 5, modified needle colposuspension in 4 and complete endoscopic excision of the urethral scars followed by open reconstruction of the bladder neck and urethra in an abdominoperineal procedure in 5. RESULTS: Conservative treatment has been completely successful in 7 patients. Primary open or needle colposuspension was unsuccessful in 6 of 9 cases, including several requiring further surgery to achieve dryness. The results of excising urethral scars with bladder neck and urethral reconstruction were good in 4 of 5 patients at a followup of at least 4 years. CONCLUSIONS: When previous internal urethrotomy appears to be an important factor in the evaluation of incontinence, conservative therapy is the treatment of choice. Conservative therapy should consist of biofeedback reeducation of the voiding pattern and physical therapy. When surgery is needed, excision of the urethral scars with reconstruction of the bladder neck and urethra plus colposuspension is superior to colposuspension only.     

青春期女性骨密度与月经状况的关系

目的 了解昆明12～14岁女性骨密度水平并就影响因素进行分析.方法 利用双能X线骨密度测定仪测量昆明市某中学98名12～14岁青少年腰椎及髋部骨密度(Bone Mineral Density,BMD), 采用问卷调查形式了解与骨密度相关因素.结果 女生腰椎、股骨颈、大转子骨密度明显高于男生(P<0.05);月经初潮年龄早的女生骨密度较高(P<0.05).结论 青春期(12～14岁)阶段女生骨密度较同年龄段男生高,该年龄段女生骨密度与月经初潮年龄有关.